IFRC: Six thousand years of urban living: Has our health improved?
By Tammam Aloudat, 'Our World. Your Move.' International Red Cross and Red Crescent Movement community blog
I am a fan of big cities; I come from Damascus, a city of more than four million people, and I have lived in London and Jakarta where crowds occupy every possible space. I loved every minute of it!
But then, with the big buzz about urbanization where more than half the people of the world live in cities now, one cannot help but wonder whether metropolitan life, despite its pleasures, can be bad for health? The question comes to my mind whenever I’m walking through polluted cities of the rich nations or streets of the massive slums of poorer ones.
Cities: A historical dilemma
Our hunter and gatherer ancestors discovered about 6,000 years ago that settling in one place allows them a much more comfortable life. They created the first cities in Mesopotamia where agriculture gave them stable food supply and allowed some of them to do other things such as making tools, raising animals, building houses, and even getting more involved in religion, government, and entertainment. Life was going well, but then things changed.
Modernization came at a price, crowding and closeness to animals allowed infectious diseases to jump from animals to people at first, and then spread among people causing epidemics. Ever since, diseases have had as much role in writing our history as did our own wars, religions, and innovations.
Old cities, new cities
You would think that cities today should be healthy. After all, we have running water, toilets, electricity, and clean food; infections surely cannot be as dangerous to city dwellers today as they were 6,000 years ago. You would be right about infections, but today’s cities can be dangerous to health in different ways.
In rich countries, people are less active, more overweight, and much more exposed to unhealthy environment that includes air, water, and food pollutants. What we call our “modern lifestyle” actually leads to increase in diseases that are not caused by infections such as heart diseases, cancers, and diabetes.
In other, less fortunate cities, slums are home to hundreds of thousands of people with no access to good services and infrastructure. They suffer from infections because of their living conditions, and from the modern lifestyle effects of living in big cities; the worst of the two worlds. They are also more at risk of disasters as we have seen in the massive earthquake in Haiti where the slums of Port-au-Prince were so badly affected; only major efforts on reconstruction, water and sanitation, and health services would help the survivors recover.
But cities are not all bad, they usually have better water supply, sanitation, and more health services; more jobs and better wages; and people have more health facilities, doctors, and nurses to see.
So, are cities a good or bad thing?
I wish this was a yes/no question! Urbanization is a risk to health, more so for people who live in slums and suffer the negative effects of poverty and those of crowding and lack of infrastructure combined. But the risk can be averted, by providing health care, prevention, empowering communities, and improving infrastructure; by doing our part in reducing pollution and making better lifestyle choices; we would be improving our own lives and those of other, both urban and rural.
Editor’s note: Tammam Aloudat is a Senior Officer in the health and community services department at the IFRC’s Geneva office. Tammam’s primary focus is emergency health.